Clinical Efficacy Of The Conjoint Fascial Sheath Suspension In The Correction Of Severe Upper Eyelid Blepharoptosis

Objective Comparative analysis of conjoint fascial sheath suspension and frontal muscle flap suspension in the correction of severe blepharoptosis,to explore the safety and clinical efficacy of conjoint fascial sheath suspension in the correction of severe blepharoptosis.Methods From September 2017 to October 2018,prospective analysis was conducted on 60 patients with severe blepharoptosis diagnosed in the plastic surgery and cosmetology center of the second people's hospital of gansu province,affiliated hospital of northwest university for nationalities,who met the inclusion criteria.They were randomly divided into a study group and a control group.30 patients in 36 eyes(6 cases in both eyes and 24 cases in one eye)were treated by conjoint fascial sheath suspension in the study group.30 patients in34 eyes(4 cases in both eyes and 26 cases in one eye)were treated by frontal muscle flap suspension in the control group.Postoperative 3 months,6 months,12 months for regular follow-up,the MRD1,degree of incomplete upper eyelid closure,lift of the upper eyelid,therapeutic effect,complications and patient satisfaction of the two groups were compared.Results Preoperative two groups of MRD1,ptosis distance,frontal muscle strength,levator muscle strength,age,and gender respectively,the difference was not statistically significant(P>0.05).With postoperative follow-up for 3 months,the study group of MRD1 was 4.32±0.13 mm,the control group was 4.04±0.17 mm;the study group of degree in incomplete upper eyelid closure was 1.39±0.27 mm,the control group was 2.12±0.41mm;the study group of lift of the upper eyelid was 4.30±0.02 mm,the control group was4.05 ± 0.03 mm;the difference was statistically significant(P<0.05).With postoperative follow-up for 6 months,the study group of MRD1 was 4.21±0.11 mm,the control group was 3.85±0.13mm;the study group of degree in incomplete upper eyelid closure was 0.80±0.29 mm,the control group was 1.26±0.30 mm;the study group of lift of the upper eyelid was 5.39±0.02 mm,the control group was 5.18±0.02 mm;the difference was statistically significant(P<0.05).With postoperative follow-up for 12 months,the study group of MRD1 was 4.34±0.11 mm,the control group was 4.21±0.18 mm;the study group of degree in incomplete upper eyelid closure was 0.12±0.13 mm,the control group was 0.23±0.11 mm;the study group of lift of the upper eyelid was 5.37±0.12 mm,the control group was 5.27±0.10 mm;the difference was statistically significant(P<0.05).With postoperative follow-upfor 12 months,the total effective rate of the study group(97.22%)was higher than that of the control group(94.12%),postoperative complications in the study group(8.33%)were lower than those in the control group(14.71%),Patient satisfaction in the study group(97.22%)was higher than that in the control group(91.18%),there were no statistically significant difference(P>0.05).Conclusion Conjoint fascial sheath suspension has advantages in higher MRD1,higher lift of upper eyelid and shorter recovery time of upper eyelid insufficiency.Conjoint fascial sheath suspension for the treatment of severe blepharoptosis has a good therapeutic effect and patient satisfaction.Conjoint fascial sheath suspension can be used as a surgical method to correct congenital,acquired and recurrent severe blepharoptosis.It is a surgical method worthy of promotion for the treatment of severe blepharoptosis.